Wednesday, November 14, 2012

A study led by a Michigan State University researcher offers the strongest evidence yet that reflexology -- a type of specialized foot massage practiced since the age of pharaohs -- can help cancer patients manage their symptoms and perform daily tasks. Funded by the National Cancer Institute and published in the latest issue of Oncology Nursing Forum, it is the first large-scale, randomized study of reflexology as a complement to standard cancer treatment, according to lead author Gwen Wyatt, a professor in the College of Nursing.

"It's always been assumed that it's a nice comfort measure, but to this point we really have not, in a rigorous way, documented the benefits," Wyatt said. "This is the first step toward moving a complementary therapy from fringe care to mainstream care."

Reflexology is based on the idea that stimulating specific points on the feet can improve the functioning of corresponding organs, glands and other parts of the body. The study involved 385 women undergoing chemotherapy or hormonal therapy for advanced-stage breast cancer that had spread beyond the breast. The women were assigned randomly to three groups: Some received treatment by a certified reflexologist, others got a foot massage meant to act like a placebo, and the rest had only standard medical treatment and no foot manipulation. Wyatt and colleagues surveyed participants about their symptoms at intake and then checked in with them after five weeks and 11 weeks.

They found that those in the reflexology group experienced significantly less shortness of breath, a common symptom in breast cancer patients. Perhaps as a result of their improved breathing, they also were better able to perform daily tasks such as climbing a flight of stairs, getting dressed or going grocery shopping. Wyatt said she was surprised to find that reflexology's effects appeared to be primarily physical, not psychological.

"We didn't get the change we might have expected with the emotional symptoms like anxiety and depression," she said. "The most significant changes were documented with the physical symptoms."

Also unexpected was the reduced fatigue reported by those who received the "placebo" foot massage, particularly since the reflexology group did not show similarly significant improvement. Wyatt is now researching whether massage similar to reflexology performed by cancer patients' friends and family, as opposed to certified reflexologists, might be a simple and inexpensive treatment option. Reflexology did not appear to reduce pain or nausea, but Wyatt said that could be because the drugs for combating those symptoms are generally quite effective, so the women may not have reported them to begin with.

Although health researchers only recently have begun studying reflexology in a scientifically rigorous way, it's widely practiced in many parts of the world and dates back thousands of years.

"Reflexology comes out of the Chinese tradition and out of Egypt," Wyatt said. "In fact, it's shown in hieroglyphics. It's been around for a very long time." Wyatt's co-authors include MSU statistics and probability professor Alla Sikorskii and College of Nursing research assistant Mei You, along with colleagues from Northwestern University and the University of Texas Health Science Center at Houston.

Tuesday, November 13, 2012

African Americans with heart disease who practiced Transcendental Meditation regularly were 48 percent less likely to have a heart attack, stroke or die from all causes compared with African Americans who attended a health education class over more than five years, according to new research published in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Those practicing meditation also lowered their blood pressure and reported less stress and anger. And the more regularly patients meditated, the greater their survival, said researchers who conducted the study at the Medical College of Wisconsin in Milwaukee.

"We hypothesized that reducing stress by managing the mind-body connection would help improve rates of this epidemic disease," said Robert Schneider, M.D., lead researcher and director of the Institute for Natural Medicine and Prevention in Fairfield, Iowa. "It appears that Transcendental Meditation is a technique that turns on the body's own pharmacy — to repair and maintain itself."

For the study, researchers randomly assigned 201 people to participate in a Transcendental Meditation stress-reducing program or a health education class about lifestyle modification for diet and exercise.

*Forty-two percent of the participants were women, average age 59, and half reported earning less than $10,000 per year.
*Average body mass index was about 32, which is clinically obese.
*Nearly 60 percent in both treatment groups took cholesterol-lowering drugs; 41 percent of the meditation group and 31 percent of the health education group took aspirin; and 38 percent of the meditation group and 43 percent of the health education group smoked.

Those in the meditation program sat with eyes closed for about 20 minutes twice a day practicing the technique, allowing their minds and bodies to rest deeply while remaining alert.

Participants in the health education group were advised, under the instruction of professional health educators, to spend at least 20 minutes a day at home practicing heart-healthy behaviors such as exercise, healthy meal preparation and nonspecific relaxation.

Researchers evaluated participants at the start of the study, at three months and every six months thereafter for body mass index, diet, program adherence, blood pressure and cardiovascular hospitalizations. They found:

*There were 52 primary end point events. Of these, 20 events occurred in the meditation group and 32 in the health education group.
*Blood pressure was reduced by 5 mm Hg and anger decreased significantly among *Transcendental Meditation participants compared to controls.
*Both groups showed beneficial changes in exercise and alcohol consumption, and the meditation group showed a trend towards reduced smoking. Although, there were no significant differences between the groups in weight, exercise or diet.
*Regular meditation was correlated with reduced death, heart attack and stroke.

Cardiovascular disease is the leading cause of death worldwide. Death from heart disease is about 50 percent higher in black adults compared to whites in the United States. Researchers focused on African Americans because of health disparities in America.

"Transcendental Meditation may reduce heart disease risks for both healthy people and those with diagnosed heart conditions," said Schneider, who is also dean of Maharishi College of Perfect Health in Fairfield, Iowa.

"The research on Transcendental Meditation and cardiovascular disease is established well enough that physicians may safely and routinely prescribe stress reduction for their patients with this easy to implement, standardized and practical program," he said.

A new study has found that participating in an 8-week meditation training program can have measurable effects on how the brain functions even when someone is not actively meditating. In their report in the November issue of Frontiers in Human Neuroscience, investigators at Massachusetts General Hospital (MGH), Boston University (BU), and several other research centers also found differences in those effects based on the specific type of meditation practiced.

"The two different types of meditation training our study participants completed yielded some differences in the response of the amygdala -- a part of the brain known for decades to be important for emotion -- to images with emotional content," says Gaëlle Desbordes, PhD, a research fellow at the Athinoula A. Martinos Center for Biomedical Imaging at MGH and at the BU Center for Computational Neuroscience and Neural Technology, corresponding author of the report. "This is the first time that meditation training has been shown to affect emotional processing in the brain outside of a meditative state."

Several previous studies have supported the hypothesis that meditation training improves practitioners' emotional regulation. While neuroimaging studies have found that meditation training appeared to decrease activation of the amygdala -- a structure at the base of the brain that is known to have a role in processing memory and emotion -- those changes were only observed while study participants were meditating. The current study was designed to test the hypothesis that meditation training could also produce a generalized reduction in amygdala response to emotional stimuli, measurable by functional magnetic resonance imaging (fMRI).

Participants had enrolled in a larger investigation into the effects of two forms of meditation, based at Emory University in Atlanta. Healthy adults with no experience meditating participated in 8-week courses in either mindful attention meditation -- the most commonly studied form that focuses on developing attention and awareness of breathing, thoughts and emotions -- and compassion meditation, a less-studied form that includes methods designed to develop loving kindness and compassion for oneself and for others. A control group participated in an 8-week health education course.

Within three weeks before beginning and three weeks after completing the training, 12 participants from each group traveled to Boston for fMRI brain imaging at the Martinos Center's state-of-the-art imaging facilities. Brain scans were performed as the volunteers viewed a series of 216 different images -- 108 per session -- of people in situations with either positive, negative or neutral emotional content. Meditation was not mentioned in pre-imaging instructions to participants, and investigators confirmed afterwards that the volunteers had not meditated while in the scanner. Participants also completed assessments of symptoms of depression and anxiety before and after the training programs.

In the mindful attention group, the after-training brain scans showed a decrease in activation in the right amygdala in response to all images, supporting the hypothesis that meditation can improve emotional stability and response to stress. In the compassion meditation group, right amygdala activity also decreased in response to positive or neutral images. But among those who reported practicing compassion meditation most frequently outside of the training sessions, right amygdala activity tended to increase in response to negative images -- all of which depicted some form of human suffering. No significant changes were seen in the control group or in the left amygdala of any study participants.

"We think these two forms of meditation cultivate different aspects of mind," Desbordes explains. "Since compassion meditation is designed to enhance compassionate feelings, it makes sense that it could increase amygdala response to seeing people suffer. Increased amygdala activation was also correlated with decreased depression scores in the compassion meditation group, which suggests that having more compassion towards others may also be beneficial for oneself. Overall, these results are consistent with the overarching hypothesis that meditation may result in enduring, beneficial changes in brain function, especially in the area of emotional processing."

Thursday, November 1, 2012

Nearly a quarter of patients with rheumatoid arthritis and osteoarthritis used complementary and alternative therapy (CAT) to help manage their condition, according to a study in the November issue of the Journal of Clinical Nursing.

Researchers interviewed 250 patients aged between 20 and 90 years of age. More than two-thirds (67%) had rheumatoid arthritis and the remainder had osteoarthritis. They found that 23% used CAT in addition to prescribed drugs and that just under two-thirds of those (64%) felt that the therapy was beneficial, reporting improvements in pain intensity, sleeping patterns and activity levels.

"Our study underlines the importance of healthcare professionals being knowledgeable about the potential use of CAT when providing medical care to patients with arthritis" says lead author Professor Nada Alaaeddine, Head of the Regenerative and Inflammation Lab in the Faculty of Medicine, University of St Joseph, Beirut, Lebanon.

"Although CAT might have beneficial effects in rheumatoid arthritis and osteoarthritis, patients should be cautious about their use and should tell their healthcare providers that they are using them to make sure they don't conflict with their existing treatment."

Key findings of the survey included:
*CAT users had an average age of 45 years, significantly younger than the average non CAT user, who was aged 57 years.
*CAT use was higher in patients with osteoarthritis (29%) than rheumatoid arthritis (20%).
*The most common CAT used was herbal therapy (83%), followed by exercise (22%), massage (12%), acupuncture (3%), yoga and meditation (3%) and dietary supplements (3%).
*Just under a quarter of the patients using CAT (24%) sought medical care because of possible side effects, but they were not serious and were reversible. The most common side effects included skin problems (16%) and gastrointestinal problems (9%).
*Just under a quarter of the patients using CAT (24%) sought medical care because of possible side effects, but they were not serious and were reversible. The most common side effects included skin problems (16%) and gastrointestinal problems (9%).
*The majority did not tell their healthcare provider about their CAT use (59%).
*CAT users were asked to rate the amount of pain they felt and the percentage who said that they experienced no pain rose from 12% to 43% after CAT use. The number who slept all night rose from 9% to 66%.
*CAT users also reported an improvement in daily activities. The percentage who said that their pain did not limit them at all rose from 3% to 12% and the percentage who said they could do everything, but with pain, rose from 26% to 52%.

"CAT use is increasing and this study shows that it provided self-reported benefits for patient with rheumatoid arthritis and osteoarthritis" says Professor Alaaeddine. "It is, however, important that patients discuss CAT use with their healthcare practitioner and that they are made aware of possible side effects, in particular the possible interactions between herbal and prescribed drugs."